Color Atlas of Hematology - Practical Microscopic and Clinical ...

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88Abnormalities of the White Cell SeriesMonocytosisIf mononuclear cells stand out in showing an unusually elaborate nuclearstructure with ridges and lobes and a wider cytoplasmic layer with verydelicate granules (for characteristics see p. 46, for cell function, see p. 6),and this is in the context of relative ( 10%) or absolute monocytosis (cellcount 900/µl), a series of possible triggers must be considered (Table12). If the morphology does not clearly identify the cells as monocytes,then esterase assays should be done in a hematological laboratory usingunstained smears.Table 12Possible causes of monocytosisInfectionNonspecific monocytosis occurs inmany bacterial infections duringrecuperation from or in the chronicphase of:– Mononucleosis (aside from stimulatedlymphocytes there are alsomonocytes)– Listeriosis– Acute viral hepatitis– Parotitis epidemica (mumps)– Chickenpox– Recurrent fever– Syphilis– Tuberculosis– Endocarditis lenta– Brucellosis (Bang disease)– Variola vera (smallpox)– Rocky mountain spotted fever– Malaria– Paratyphoid fever– Kala-azar– Thypus fever– Trypanosomiasis (African sleepingsickness)Chronic reactive condition of theimmune system, e. g., in:– Autoimmune diseases– Chronic dermatoses– Regional ileitis– SarcoidosisParaneoplasm(as attempted immune defense),e. g., in:– Large solid tumors– LymphogranulomatosisNeoplasm– Chronic myelomonocyticleukemia (CMML, p. 107)– Acute monocytic leukemia(p. 100)– Acute myelomonocytic leukemia(p. 98)
Conspicuously large numbers of monocytes usually indicate areactive disorder. Only a monotonous predominance of monocytessuggests leukemiaabcFig. 30 Reactive monocytosis and monocytic leukemia. a Reactive and neoplasticmonocytes are morphologically indistinguishable; here two relatively condensedmonocytes in reactive monocytosis are shown. b Whenever monocytes arefound exclusively, a malignant etiology is likely: in this case AML M 5 b according tothe FAB classification (see p. 100). Auer bodies (arrow). c Monocytes of differentdegrees of maturity, segmented neutrophilic granulocytes (1), and a small myeloblast(2) in chronic myelomonocytic leukemia (CMML, see p. 107).89
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iiiColor Atlas of HematologyPractic
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vPrefaceOur Current EditionAlthough
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viiContentsPhysiology and Pathophys
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ContentsixAcute Lymphoblastic Leuke
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2Physiology and Pathophysiology of
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Normal Cells of the Blood andHemato
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Normally erythropoiesis takes place
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34Normal Cells of the Blood and Hem
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36Normal Cells of the Blood and Hem
Page 49 and 50: Advancing nuclear contraction and s
Page 51: Note the granulations, inclusions,
Page 54 and 55: 44Normal Cells of the Blood and Hem
Page 71 and 72: Abnormalities of the White Cell Ser
Page 73 and 74: Predominance of Mononuclear Round t
Page 77 and 78: During lymphatic reactive states, v
Page 79 and 80: Extreme transformation of lymphocyt
Page 85 and 86: Monotonous proliferation of small l
Page 87 and 88: Atypical lymphocytes are not part o
Page 89 and 90: Deep nuclear indentation suggests f
Page 91 and 92: Cytoplasmic processes the main feat
Page 93 and 94: Plasmacytoma cannot be diagnosed wi
Page 95 and 96: Atypias and differential diagnoses
Page 97: Bone marrow diagnosis is indicated
Page 107 and 108: Fundamental characteristic of acute
Page 109 and 110: The diagnosis of acute leukemia is
Page 111 and 112: Acute leukemias may also derive fro
Page 113 and 114: New WHO classification: AML with dy
Page 115 and 116: The cells in acute lymphocytic leuk
Page 117 and 118: In unexplained anemia and/or leukoc
Page 119 and 120: The classification of myelodysplasi
Page 121 and 122: Prevalence of Polynuclear (Segmente
Page 123 and 124: Predominance of the granulocytic li
Page 125 and 126: Prevalence of Polynuclear (Segmente
Page 127 and 128: Left shift as far as myeloblasts, p
Page 129 and 130: Bone marrow analysis is not obligat
Page 131 and 132: In the course of chronic myeloid le
Page 133 and 134: Enlarged spleen and presence of imm
Page 135 and 136: Eosinophilia and basophilia are usu
Page 137 and 138: Erythrocyte and ThrombocyteAbnormal
Page 139 and 140: Hypochromic Anemias129Insufficient
Page 141 and 142: Hypochromic Anemias131BSGIron Ferri
Page 143 and 144: Small, hemoglobin-poor erythrocytes
Page 145 and 146: Hypochromic erythrocytes of very va
Page 147 and 148: Hypochromic Anemias137Hypochromic S
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Hypochromic anemia without iron def
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Consistently elevated “young” e
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Distribution pattern and shape of e
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Conspicuous erythrocyte morphology
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Unexplained decrease in cell counts
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Hypochromic Anemias149Differential
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Thrombocytopenia with leukocytosis
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Conspicuous large erythrocytes sugg
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In older patients, myelodysplastic
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Small inclusions are usually a sign
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PlasmodiumfalciparumPlasmodiumvivax
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Conspicuous erythrocyte inclusions
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Bone marrow analysis contributes to
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Thrombocytes: increases, reductions
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Thrombocytes: increases, reductions
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Variant forms of thrombocyte and me
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Thrombocyte proliferation with larg
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Cytology of Organ Biopsiesand Exuda
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Lymph Node Cytology175Anamnesis- su
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Reactive lymph node hyperplasia and
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Lymph Node Cytology179Contact witha
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Epithelioid cells dominate the lymp
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In cases of non-Hodgkin lymphoma an
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Accessible cysts (e.g., branchial c
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Tumor cells can be identified in pl
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Viral, bacterial, and malignant men
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191IndexAActinomycosis 179Addison d
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Index193Disseminated intravascularc
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Index195blast crisis 120-121bone ma
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Index197in hemolytic anemia 140orth
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